Drug Utilization Patterns and Adherenceto Guideline-Directed Therapy in Acute Myocardial Infarction: A ProspectiveObservational Study

International Journal of Life Sciences, Biotechnology andPharma Research Vol. 14, No. 10, October 2025 DOI:10.69605/ijlbpr_14.10.2025.11

ABSTRACT

Background: Acute myocardial infarction (AMI) is aleading cause of morbidity and mortality worldwide. Effective pharmacotherapy plays a crucial role in secondary prevention and improving clinical outcomes. This study evaluates drug utilization patterns in Acute myocardial infarction patients,adherence to guideline-recommended therapies, and factors influencing medication adherence.

Methods: A prospective observational study was conducted on 100 Acute myocardial infarction patients. Demographic data, comorbidities, Killip class, left ventricular ejection fraction (LVEF), and drug utilization were analyzed. Adherence to guideline-recommended therapies, including dual antiplatelet therapy (DAPT), beta-blockers, ACE inhibitors/ARBs, statins, and SGLT2 inhibitors, was assessed based on the American College of Cardiology (ACC) and American Heart Association (AHA) guidelines.

Results: The study included 100 patients (mean age: 54.27 ± 13.51 years), with 82% males. Most (81%) were Killip class I, indicating mild heart failure. Hypertension (34%) and diabetes (24%) were common, while 58% reported tobaccouse. LVEF was <30% in 18% of patients. Thrombolysis was performed in 95%, predominantly with streptokinase (94%). DAPT adherence was high (98%), with ticagrelor (58%) being the most prescribed. Beta-blockers were used in 62%, andACE inhibitors/ARBs in 44%. PCI was performed in 67%, primarily for Left Anterior Descending  lesions. AWMI was the most common MI type (45%). Adherence to ACC/AHA guidelines was high for antiplatelets (98%) and statins(96%), but suboptimal for betablockers (62%) and ACE inhibitors/ARBs (44%). Older patients had lower adherence to guideline-directed therapies.

Conclusion: The study demonstrates high adherence toantiplatelets and statins but suboptimal beta-blocker and ACE inhibitor/ARB use. Streptokinase was the preferred thrombolytic. Targeted interventions are needed to improve adherence, especially in older patients, to optimize Acutemyocardial infarction management and outcomes.

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